Organization Active NPI

Ritenour Medical LLC

  • Primary Care Clinic/Center
  • Mansfield, OH
National Provider Identifier
1780226092
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
RITENOUR MEDICAL LLC
Practice address
380 Cline Ave Ste 1
Mansfield, OH 44907-1056
Phone
(419) 571-5290
Fax
(419) 522-0998
NPI assigned
Oct 9, 2019
Last updated
Feb 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul E RitenourNPI 1598726028
Title
Owner
Phone
(419) 571-5290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

380 Cline Ave Ste 1
Mansfield, OH 44907-1056

Mailing address

380 Cline Ave Ste 1
Mansfield, OH 44907-1056
Phone (419) 571-5290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200325002591 OH Part B Supplier - Clinic/Group Practice 1759719727 Receives reassigned benefits from 2 practitioners
Practice locations: Mansfield, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1780226092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CLINE AVE STE 1",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071056",
            "telephone_number": "419-571-5290",
            "fax_number": "419-522-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CLINE AVE STE 1",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071056",
            "telephone_number": "419-571-5290",
            "fax_number": "419-522-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITENOUR MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "RITENOUR",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-571-5290"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.